This form contains 130 fields organized into 31 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Additional Information
Additional Information Notes	Text	Provide any additional information or notes regarding the documentation presented by the employee, or other relevant details as required by the instructions.
Alien Authorized to Work Documentation
USCIS A-Number	Text	Please provide your USCIS Alien Registration Number (A-Number). Fill only if 'A noncitizen (other than Item Numbers 2. and 3. above) authorized to work' is 'Yes'. Max length: 10 characters Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Form I-94 Admission Number	Text	Please provide your Form I-94 Admission Number. Fill only if 'A noncitizen (other than Item Numbers 2. and 3. above) authorized to work' is 'Yes'. Max length: 11 characters Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Foreign Passport Number and Country of Issuance	Text	Please provide your foreign passport number and the country that issued it. Fill only if 'A noncitizen (other than Item Numbers 2. and 3. above) authorized to work' is 'Yes'. Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Citizenship Status
A citizen of the United States	Checkbox	Check this box if you are a citizen of the United States.
A noncitizen national of the United States	Checkbox	Check this box if you are a noncitizen national of the United States.
A lawful permanent resident	Checkbox	Check this box if you are a lawful permanent resident.
Lawful Permanent Resident Number	Text	Provide the USCIS A-Number or Permanent Resident Number if you are a lawful permanent resident. Fill only if 'A lawful permanent resident' is 'Yes'. Depends on: A lawful permanent resident
A noncitizen (other than Item Numbers 2. and 3. above) authorized to work	Checkbox	Check this box if you are a noncitizen (other than a noncitizen national or lawful permanent resident) who is authorized to work.
Work Authorization Expiration Date	Date	Enter the date your work authorization expires. Fill only if 'A noncitizen (other than Item Numbers 2. and 3. above) authorized to work' is 'Yes'. Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Document (List B)
Document Title (List B)	Text	Enter the title of the document from List B that establishes the employee's identity and employment authorization.
Issuing Authority (List B)	Text	Enter the name of the authority that issued the document from List B.
Document Number (List B)	Text	Enter the identification number of the document from List B, if applicable.
Expiration Date (List B)	Date	Enter the expiration date of the document from List B, if applicable.
Document (List C)
Document Title (List C)	Text	Enter the title of the document from List C.
Issuing Authority (List C)	Text	Enter the name of the authority that issued the List C document.
Document Number (List C)	Text	Enter the document number for the List C document, if applicable.
Expiration Date (List C)	Date	Enter the expiration date for the List C document, if applicable.
Employee Address
Street Address	Text	Provide the street number and name of the employee's current residential address.
Apartment Number	Text	Enter the apartment, suite, or unit number, if applicable.
City	Text	Provide the city or town of the employee's current residential address.
ZIP Code	Text	Enter the five-digit or nine-digit ZIP code for the employee's current residential address. Max length: 6 characters
Employee Attestation
Employee Signature	Text	Please provide your electronic signature as the employee.
Today's Date	Date	Please enter today's date.
Employee Information
State	Combobox	Please provide the state of your current address. AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY CAN MEX
Employee Name
Last Name	Text	Enter the employee's last name or family name.
First Name	Text	Enter the employee's first name or given name.
Middle Initial	Text	Enter the employee's middle initial, if applicable. Max length: 1 characters
Other Last Names Used	Text	Enter any other last names the employee has used, if applicable.
Last Name	Text	Enter the employee's last name (family name) as it was entered in Section 1 of Form I-9.
First Name	Text	Enter the employee's first name (given name) as it was entered in Section 1 of Form I-9.
Middle Initial	Text	Enter the employee's middle initial, if any, as it was entered in Section 1 of Form I-9.
Employee Name from Section 1
Employee Last Name	Text	Provide the employee's last name (family name) as it appears in Section 1.
Employee First Name	Text	Provide the employee's first name (given name) as it appears in Section 1.
Employee Middle Initial	Text	Provide the employee's middle initial, if applicable, as it appears in Section 1.
Employee Personal and Contact Details
Date of Birth	Date	Please provide your date of birth.
U.S. Social Security Number	Text	Please enter your U.S. Social Security Number. Max length: 9 characters
Employee's Email Address	Text	Please provide your employee email address.
Employee's Telephone Number	Text	Please enter your employee telephone number.
Employer Certification
Alternative Procedure	Checkbox	Check this box if you used an alternative procedure authorized by the Department of Homeland Security (DHS) to examine the employee's documents.
First Day of Employment	Date	Enter the first day the employee started working.
Employer or Authorized Representative Name and Title	Text	Provide the last name, first name, and title of the employer or authorized representative.
Employer or Authorized Representative Signature	Text	Provide the signature of the employer or authorized representative.
Today's Date	Date	Enter today's date when the employer or authorized representative signed.
Employer's Business or Organization Name	Text	Enter the full legal name of the employer's business or organization.
Employer's Business or Organization Address	Text	Enter the full address of the employer's business or organization, including city or town, state, and ZIP code.
First Document (List A)
Document Title (List A)	Text	Enter the exact title of the List A document you examined, as it appears on the document (for example, “U.S. Passport,” “Permanent Resident Card,” or “Employment Authorization Document”). Complete this field only if you are documenting with a List A document; if you are using List B and List C documents instead, leave this field blank. No additional formatting is required.
Issuing Authority	Text	Please provide the name of the authority that issued the first document from List A.
Document Number	Text	Please provide the document number for the first document from List A.
Expiration Date	Date	Please provide the expiration date of the first document from List A.
Document Title 1	Text	Please provide the title of the first document presented from List A.
First Document Information
Document Title	Text	Provide the title of the document used for reverification. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Document Number	Text	Provide the document number from the reverification document, if applicable. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Document Expiration Date	Date	Provide the expiration date of the reverification document, if applicable. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
First Employer Attestation
Employer or Authorized Representative Name	Text	Enter the name of the employer or authorized representative.
Signature of Employer or Authorized Representative	Text	Provide the signature of the employer or authorized representative.
Today's Date	Date	Enter today's date.
First Preparer/Translator Certification
Signature	Text	Provide the signature of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Date	Date	Enter the date of certification. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Last Name	Text	Provide the last name (family name) of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
First Name	Text	Provide the first name (given name) of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Middle Initial	Text	Provide the middle initial of the preparer or translator, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 1 characters
Street Address	Text	Provide the street number and name of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
City or Town	Text	Provide the city or town of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
State	Combobox	Provide the state of the preparer or translator's address. AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY CAN MEX
ZIP Code	Text	Provide the ZIP code of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 6 characters
First Rehire/Name Change Information
Date of Rehire	Date	Enter the date the employee was rehired.
New Last Name	Text	Enter the employee's new last name (family name).
New First Name	Text	Enter the employee's new first name (given name).
New Middle Initial	Text	Enter the employee's new middle initial, if applicable. Max length: 1 characters
First Section Additional Information
Additional Information	Text	Please provide any additional information, including initials and the date for each notation.
Alternative Procedure	Checkbox	Check this box if you used an alternative procedure authorized by DHS to examine documents.
Fourth Preparer/Translator Certification
Preparer/Translator Signature	Text	Provide the signature of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Date of Signature	Date	Enter the date the preparer or translator signed this certification. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Last Name	Text	Enter the last name (family name) of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator First Name	Text	Enter the first name (given name) of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Middle Initial	Text	Enter the middle initial of the preparer or translator, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 1 characters
Preparer/Translator Street Address	Text	Enter the street number and name of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator City or Town	Text	Enter the city or town of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator State	Combobox	Enter the state of the preparer or translator's address. AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY CAN MEX
Preparer/Translator ZIP Code	Text	Enter the ZIP Code of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 6 characters
Second Document (List A)
Document 2 Title	Text	Enter the title of the second document provided from List A.
Document 2 Issuing Authority	Text	Provide the name of the entity that issued the second document from List A.
Document 2 Number	Text	Enter the unique identification number for the second document from List A.
Document 2 Expiration Date	Date	Enter the expiration date of the second document from List A.
Second Document Information
Document Number	Text	Please enter the identifying number of the document used for reverification. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Expiration Date	Date	Please provide the expiration date of the document. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Second Employer Attestation
Employer/Representative Name	Text	Provide the full name of the employer or authorized representative who is attesting for this second reverification/rehire.
Employer/Representative Signature	Text	Provide the signature of the employer or authorized representative for this second reverification/rehire.
Today's Date	Date	Provide the current date.
Second Preparer/Translator Certification
Preparer/Translator Signature Name	Text	Enter the full name of the preparer or translator who is attesting to the completion of the form. This serves as their written signature. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Certification Date	Date	Provide the date the preparer or translator signed this certification. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
First Preparer or Translator Last Name (Family Name)	Text	Enter the last name (family name) of the first preparer or translator signing the Preparer and/or Translator Certification for Section 1 of Form I-9. Required if you assisted the employee in completing Section 1 of Form I-9. Type or print your full surname exactly as you want it to appear; do not use initials or abbreviations. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Last Name	Text	Enter the last name (family name) of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator Middle Initial	Text	Enter the middle initial of the preparer or translator, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 1 characters
Preparer/Translator Street Address	Text	Enter the street number and name for the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator City or Town	Text	Enter the city or town for the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer/Translator State	Combobox	Enter the state for the preparer or translator's address. AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY CAN MEX
Preparer/Translator ZIP Code	Text	Enter the ZIP code for the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 6 characters
Second Rehire/Name Change Information
Second Date of Rehire (if applicable)	Text	Enter the date on which the employee was rehired for the second time, in MM/DD/YYYY format. Only complete this field when using a new section for a subsequent rehire; leave blank if not applicable.
Second New Name - Last Name (Family Name)	Text	Enter the employee's current legal last name in the "New Name (if applicable)" section for the second rehire or reverification event. Only complete this field if you are completing a second rehire or reverification within three years of the date the original Form I-9 was completed. Use the exact spelling as it appears on the employee's supporting documentation.
Second New First Name (Given Name)	Text	In the second “New Name (if applicable)” section, enter the employee’s current legal first (given) name exactly as shown on their legal documents. Complete this field only if you have provided a second “Date of Rehire (if applicable)” entry; otherwise leave it blank. Use only alphabetic characters and do not include punctuation.
New Middle Initial (Second Rehire)	Text	In the second “New Name (if applicable)” section for Rehire, enter the employee’s new middle initial. Only complete this field if the employee is being rehired a second time and their new name includes a middle initial; otherwise leave it blank. Enter exactly one alphabetic character (A–Z). Max length: 1 characters
Second Section Additional Information
Additional Information	Text	Provide any additional information, including initials and the date for each notation, related to the reverification or rehire.
Alternative Procedure Used	Checkbox	Check this box if you used an alternative procedure authorized by DHS to examine the employee's documents.
Third Document (List A)
Document Title 3 (List A)	Text	Enter the title of the third document presented from List A.
Issuing Authority (List A, Document 3)	Text	Provide the name of the authority that issued the third document from List A.
Document Number (List A, Document 3)	Text	Enter the document number for the third document from List A.
Expiration Date (List A, Document 3)	Date	Enter the expiration date of the third document from List A.
Third Document Information
Third Document Title	Text	Provide the title of the third document presented for reverification or rehire. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Third Document Number	Text	Provide the document number for the third document, if applicable. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Third Document Expiration Date	Date	Provide the expiration date for the third document, if applicable. Fill only if 'Citizenship/Immigration Status' is 'A noncitizen authorized to work' Depends on: A noncitizen (other than Item Numbers 2. and 3. above) authorized to work
Third Employer Attestation
Third Employer Name	Text	Provide the name of the employer or authorized representative for this third attestation section.
Third Employer Signature	Text	Provide the signature of the employer or authorized representative for this third attestation section.
Third Attestation Date	Date	Provide today's date for this third attestation section.
Third Preparer/Translator Certification
Preparer Signature	Text	Provide the signature of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Certification Date	Date	Enter the date of the certification. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer Last Name	Text	Enter the last name of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer First Name	Text	Enter the first name of the preparer or translator. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer Middle Initial	Text	Enter the middle initial of the preparer or translator, if applicable. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 1 characters
Preparer Street Address	Text	Enter the street number and name of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer City or Town	Text	Enter the city or town of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'.
Preparer State	Combobox	Enter the state of the preparer or translator's address. AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY CAN MEX
Preparer ZIP Code	Text	Enter the ZIP code of the preparer or translator's address. Fill only if 'A preparer and/or translator assisted' is 'Yes'. Max length: 6 characters
Third Rehire/Name Change Information
Rehire Date	Date	Please enter the date the employee was rehired, if applicable.
New Last Name	Text	Please enter the employee's new last name, if applicable.
New First Name	Text	Please enter the employee's new first name, if applicable.
New Middle Initial	Text	Please enter the employee's new middle initial, if applicable. Max length: 1 characters
Third Section Additional Information
Additional Information Notes	Text	Provide any additional information, including your initials and the date for each notation.
Alternative Procedure	Checkbox	Check this box if you used an alternative procedure authorized by DHS to examine documents for this reverification/rehire event.

Form I-9, Employment Eligibility Verification Instructions